Tips for Traveling with Gout

Four years ago, I started practicing pharmacy in a tourist area, so I see at lot of out-of-town visitors at the counter. When one of these customers asked for my advice recently, I knew exactly what to do. He had left his gout medicine at home, and wanted to know if some over-the-counter Advil might “get me by until I can get home.”

“Yes” I said, “But we can do better than that.” Much to his surprise, I was able to look up his prescription profile, refill his prescription, call his insurance company for a vacation override, and send him on his way with a new supply.

That is the most important thing to remember about your prescriptions while traveling. Most chain pharmacies today use common prescription databases, and most insurance companies will grant overrides to pay for an emergency supply of medication.

Don’t worry if you can’t find the chain store you normally use. If you find yourself away from home without your prescriptions, almost any pharmacy will be able to take care of you. What can’t be done electronically can be done with a phone call between two pharmacists.

Medicines to take with you

Having access to your prescriptions to prevent gout may not help if you suffer an acute attack while traveling. Ask your doctor about writing a prescription to treat a gout attack that you can take with you when you’re traveling. This will most likely be an anti-inflammatory steroid such as prednisone and/or a non-steroidal anti-inflammatory drug (NSAID) such as indomethacin, naproxen, or ibuprofen. Both types of anti-inflammatories can cause stomach upset, so it’s a good idea to pack an antacid along with those spare prescriptions.

Don’t use aspirin to treat a gout attack. At the standard pain-relieving dose of 650 to 1000mg every 6 hours, aspirin can increase the level of uric acid in your bloodstream, as well as interact with the prescription gout medicines probenecid and sulfinpyrazone. A low-dose “baby aspirin” however, is generally not a problem for people with gout.

Colchicine, another medicine often used to treat gout attacks, has recently been found to be safer and just as effective at a dose lower than what had been normally prescribed. If you use colchicine, ask your doctor if a lower dosage could be right for you.

Don’t order grapefruit juice at breakfast if you take colchicine, as it can increase the level of the drug in your bloodstream.

Foods to avoid

Avoiding some of the temptations that come with being on vacation may be just as important as bringing the right medicine with you. Any form of alcohol can increase the risk of a gout attack. Beer carries the highest risk of triggering an attack, as it is high in purines, which are metabolized into uric acid in the body.

Other purine-rich foods include organ meats such as liver or kidney, seafood such as anchovies and sardines, gravies, mushrooms and spinach. Sticking to a low-purine diet, as well as remembering to drink lots of water may be the difference between coming into the drugstore looking for my help and coming in just to buy a souvenir.